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Malcher et al. Mini-invasive Surg 2021;5:31 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.48

Opinion Open Access

Robotic-assisted approach for complex inguinal

hernias

1
2
1
Flavio Malcher , Diego L. Lima , Raquel N. Cordeiro L. Lima , Prashanth Sreeramoju 1
1
Department of Surgery, Montefiore Medical Center, The Bronx, New York, NY 10461, USA.
2
Department of Surgery, Pernambuco Health College, Recife 51150-000, Brazil.
Correspondence to: Dr. Flavio Malcher, Department of Surgery, Montefiore Medical Center, 1825 Eastchester Rd, The Bronx,
New York, NY 10461, USA. E-mail: fmalcher@montefiore.org
How to cite this article: Malcher F, Lima DL, Lima RNCL, Sreeramoju P. Robotic-assisted approach for complex inguinal hernias.
Mini-invasive Surg 2021;5:31. https://dx.doi.org/10.20517/2574-1225.2021.48

Received: 2 Apr 2021 First Decision: 20 Apr 2021 Revised: 28 Apr 2021 Accepted: 7 May 2021 First online: 15 Jun 2021

Academic Editor: William W. Hope Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Laparoscopic inguinal hernia repair was introduced in the early nineties as a minimally invasive alternative to the
classic Lichtenstein repair. Over the decades, minimally invasive approaches have demonstrated both
postoperative benefits and easy replicability. Robotic inguinal hernia repair has been shown as a safe alternative to
laparoscopic repair. Furthermore, due to technical difficulties, complex inguinal hernia repairs (scrotal hernias,
incarcerated hernias, recurrent hernias, mesh removal, and previous pelvic surgery) are a relative contraindication
for laparoscopic repairs. In this article, we highlight the advantages of the robotic approach for complex cases of
inguinal hernia.

Keywords: Robotic surgery, inguinal hernia, abdominal wall, minimally invasive surgical procedures

INTRODUCTION
Laparoscopic inguinal hernia repair was introduced in the early nineties as a minimally invasive alternative
to the classic Lichtenstein repair . Over the next decades, two different minimally invasive approaches have
[1]
been extensively published: totally extraperitoneal repair (TEP) and transabdominal preperitoneal repair
(TAPP), demonstrating both postoperative benefits and easy replicability . Recently, minimally invasive
[2-4]
surgery (MIS) has become the gold standard approach for bilateral inguinal hernia repair and has also been
suggested for primary and recurrent unilateral inguinal hernias when expertise is present . With the
[5]

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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